CASSIDY WYATT (OD) – Optometrist, NPI 1760237465

CASSIDY WYATT (OD) is a healthcare provider. based in Detroit, Michigan. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 4901005824 (MI). The NPI Number for CASSIDY WYATT (OD) is 1760237465

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
CASSIDY WYATT (OD)
NPI
1760237465
Phone
Not provided
Address
4646 JOHN R ST
Enumeration Date
17 April 2024
Last Update Date
29 July 2024

Doctor Profile

Medical School Name
FERRIS STATE COLLEGE - COLLEGE OF OPTOMETRY
Secondary Phone
5867756733
Graduation Year
2019 (7 years ago)
PAC ID
5698213775
Group Practice PAC ID
8325192859
Professional Enrollment ID
I20240820003953
Address ID
MI480801448SA23620AVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience33
Completeness75
Years active:2State licenses:1Digital endpointsOther names

1,204 OPTOMETRY in MI

Provider Addresses for CASSIDY WYATT (OD)

  • 4646 JOHN R ST

    DETROIT, MI 482011916

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $224.

Total Amount is formed as General ($224) + Research ($0) + Ownership ($0) = $224.

Last reported payment date: 2024-12-05 • Largest payer in this snapshot: SUN PHARMACEUTICAL INDUSTRIES INC. ($105).

Total Amount

$224

General + Research + Ownership

Payments

3

Total payment records

General Amount

$224

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-05

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-08-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240820003953IOptometryMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48201)

Loading plans...

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8325192859View full group profile
NameSpecialtyState
O P T O M E T R YMI
O P T O M E T R YMI
O P T O M E T R YMI
O P T O M E T R YMI
-MI
-MI
O P T O M E T R YMI
O P T O M E T R YMI
O P T O M E T R YMI
-MI

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What NPI should I save for CASSIDY WYATT (OD)?
Save NPI 1760237465 if you need a stable reference for CASSIDY WYATT (OD).
Is CASSIDY WYATT (OD)'s NPI currently valid?
The extract we use shows CASSIDY WYATT (OD) as active.
What kind of provider is CASSIDY WYATT (OD)?
The page reflects Optometrist for CASSIDY WYATT (OD). Clinical services aligned with this taxonomy classification.
What location shows for CASSIDY WYATT (OD)?
We surface Detroit, Michigan for CASSIDY WYATT (OD) based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

Similar Providers

15157, Gratiot Avenue, Mohican Regent, Detroit, Wayne County, Michigan, 48205, United States
NPI: 1013909555
10174 OTTER DR
NPI: 1669438263
1560, East Maple Road, Troy, Oakland County, Michigan, 48083, United States
NPI: 1063452233

UNIVERSITY EYE PHYSICIANS

Ophthalmology Physician
The Plaza, 3800, Woodward Avenue, Midtown, Detroit, Wayne County, Michigan, 48201, United States
NPI: 1942233945
4732, Maura Lane, West Bloomfield Township, Oakland County, Michigan, 48323, United States
NPI: 1235154220
Henry Ford Hospital, 2799, West Grand Boulevard, New Center, Detroit, Wayne County, Michigan, 48202, United States
NPI: 1629093562
River Road, Detroit, Somerset County, Maine, 04929, United States
NPI: 1447263157
Detroit Receiving Hospital and University Health Center, 4201, Saint Antoine Street, Medical Center, Midtown, Detroit, Wayne County, Michigan, 48201, United States
NPI: 1285742981
Livernois Avenue, Detroit, Wayne County, Michigan, 48238, United States
NPI: 1285728964